Help for Jewish Women

Observant Jewish women who struggle with eating disorders now have a religiously sensitive treatment option close to home. Last fall, the Renfrew Center, long recognized as a leading provider of eating disorders treatment, opened a site in Towson. On May 21, the center will present “Feasting, Fasting and Eating Disorders” a seminar for health and mental health professionals, educators and clergy on eating disorders in the Jewish community.

Adina Fradkin, who is Jewish, is a registered dietician at the new treatment center. Fradkin hopes the Towson location’s special track for Orthodox Jewish girls and women will encourage them to feel more comfortable seeking help. She believes that shame may be a contributing factor to the reluctance of some in the Orthodox community to address their eating disorders.

According to Renfrew’s research department, a 2008 study from Toronto published in the The American Journal of Psychiatry found that 25 percent of Jewish females ages 13 to 20 reported eating disorder behaviors, compared with just 18 percent in other religious affiliations. Another study published in 2004 in the journal Epidemiology found that Jewish women between the ages of 36 and 45 were twice as likely to meet criteria for an eating disorder as women in the same age group affiliated with other religions. Between 2007 and 2012, 8.5 percent of patients seeking residential treatment at the Renfrew Center were Jewish.

Sarah Bateman, the Renfrew Center’s Jewish liaison, is not convinced there is enough evidence to substantiate the claim that Jewish women are more prone to suffering from eating disorders, but she noted that Renfrew has seen more Jewish women seeking treatment for eating disorders in recent years.

“We have explored the possibilities that Jews may be seeking treatment more than the general population,” said Bateman. “Over the past few years there has been more recognition of eating disorders in the Jewish community, thus perhaps lowering the stigma and increasing the number of people seeking treatment.”

One thing that makes Renfrew a more comfortable environment for Orthodox girls and women from the get-go, said Fradkin, is the fact that the center only treats female patients.

“That is such a benefit to a young Jewish girl who has gone to an all-girls school and is not used to being around boys,” explained Fradkin. “She might not feel comfortable sharing her feelings in a mixed group.”

In addition to having Jewish clinicians on staff, Renfrew’s Jewish track approaches such religiously rooted themes as Bishvili Nivra Ha’Olam (“self-esteem”), Shidduch V’Zivuggim (“dating and marriage”), HaGuf beMar’eh (“body image”), Sh’ma beKoli (“my voice”) and the place of food in Jewish life with sensitivity and an understanding about Orthodox Jewish customs.

“It’s nice for people to feel they are not speaking a different language. In order to treat Orthodox women, you need to be aware of dietary laws, holidays, dress and the role of food in Jewish culture,” said Fradkin with a chuckle. “It seems we are always eating!”

“I’ll give you just one example,” said Bateman. “It’s Passover. We have found that 80 percent of Jews, regardless of affiliation, attend a Seder. This is stressful for all Jews but even more stressful for someone with an eating disorder. It is [one of the] most restrictive times for eating. Even the recurrence of the Sabbath meal every week is stressful.

“I often do a pre-Passover seminar to help patients before the holiday,” she added. “Imagine how much stress someone with an eating disorder might feel before Thanksgiving? It’s eight days straight for Passover!”

An additional stressor for Orthodox girls and women, said Fradkin, is the fact that “these women are on a timeline to some extent. They’re done with school and studies, then they are getting matched and dating and getting married. Treatment can be an impediment to that timeline.”

The Renfrew Center offers a continuum of care, ranging from residential treatment at their Philadelphia and Coconut Creek, Fla., locations to day treatment, intensive outpatient treatment and individual treatment programs all located at the Baltimore site. “As part of our assessment, we provide recommendations for the treatment level that we feel best fits the need of the patient,” said center director Genny Roanhouse.

Patients in Renfrew’s day treatment program eat two supervised meals at the center, and those in the intensive outpatient program eat one supervised meal there. In order to meet the needs of their Orthodox patients, the Renfrew Center serves food prepared under the strict supervision of Orthodox rabbis. These meals comply with USDA guidelines that meet standards for moderation, balance and variety of food groups.

“At least one staff member eats with the patients at every meal,” said Fradkin. “The staff member eats exactly the same food the patients eat and can model healthy eating for them. After each meal, there is a meal support group, where we process everything that happened during the meal. Was there something they struggled with? Or maybe it went really well and they tried a new food. We have challenge meals where we serve foods that the patients haven’t allowed themselves to eat. It’s a great way to show that there are no good foods or bad foods. It’s all about moderation.”

In addition to the regular mealtimes and challenge programs, Roanhouse said that the program includes family meals.

“During treatment, each patient has the opportunity to have her family bring a meal for them to eat at the center together,” said Roanhouse. “A therapist is at the meal to monitor conversation. It’s a great teaching tool.”